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General NPI Number Information
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NPI Number | 1538785704
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Entity Type | Organization
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Legal Business Name | K CARE IPA
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Dates
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Enumeration Date | 06/23/2020
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Last Update Date | 06/23/2020
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Provider Practice Location Address
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Address Line | 18000 STUDEBAKER RD STE 100
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City | CERRITOS
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State | CA
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Zip | 90703
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Country | US
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Telephone | 323-391-8887
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Fax |
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Provider Business Mailing Address
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Address Line | 18000 STUDEBAKER RD STE 100
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City | CERRITOS
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State | CA
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Zip | 90703
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | VINCENT L ANTHONY
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Credential | MD, MPH, FASN, CHCQ,
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Telephone | 323-391-8887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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